LEEP术中宫颈管黏膜环切预防宫颈柱状上皮外翻的效果分析

Effect of Cervical Canal Mucosa Circumcision in LEEP Surgery on Preventing Cervical Columnar Epithelium Valgus

目的：探讨宫颈环形电切术（ LEEP ）行宫颈管黏膜环切预防术后宫颈柱状上皮外翻的临床效果。方法宫颈疾病患者180例，采用抽签法随机分为两组：对照组90例采用环形或锥形电极切除宫颈和宫颈管组织；研究组90例先切除宫颈和宫颈管组织，再用小环形电极伸入宫颈管0．4～0．6 cm纵形切除颈管黏膜组织。比较两组术中出血量、手术时间、疗效、宫颈机能及术后宫颈柱状上皮外翻的发生率。结果术后1、2个月，研究组宫颈柱状上皮外翻发生率为4．44％、2．22％，均明显低于对照组的16．67％、14．44％（P＜0．05）；研究组术后1个月治愈率为88．89％（80/90）、有效率11．11％（10/90）、无效0例，2个月分别为95．56％（86/90）、4．44％（4/90）、0例；对照组1个月治愈率为76．67％（69/70）、有效率为23．33％（21/90）、无效0例，2个月分别为80．00％（72/90）、20．00％（18/90）、0，研究组疗效均优于对照组（P＜0．05）。两组术中出血量、手术时间比较，差异无统计学意义（ P＞0．05）。术后6个月两组患者均无宫颈管松弛和宫颈管狭窄发生。结论 LEEP术中颈管黏膜环切可有效预防术后宫颈柱状上皮外翻的发生。

Objective To evaluate the effect of cervical canal mucosa circumcision in loop electrosurgical excision procedure （ LEEP） surgery on cervical columnar epithelium valgus .Methods One hundred and eighty cases of cervical diseases were divided into two groups randomly .Ninety cases in the control group underwent the circular or conical electrode excision of the cervix uteri and cervical tissue .Ninety cases in the study group underwent the excision of the cervix and cervical tissue firstly ,and then were inserted into the cervical canal 0.4-0.6 cm with the small ring electrode to excise the mucosal neck longitudinally .The amount of intraoperative bleeding , time of surgery , curative effect,cervical function ,and the incidence of cervical columnar epithelium valgus after surgery were compared between two groups.Results One and 2 months after surgery,the incidences of cervical columnar epithelium valgus in the study group was 4.44% and 2.22%,respectively,significantly lower than those （16.67%,14.44%） in the control group（P〈0.05）.One month after surgery,the cure rate in the study group was 88.89%（80/90）,the effective rate was 11.11%（10/90）,invalid 0 cases.Two months after surgery ,the cure rate in the study group was 95.56%（86/90）,the effective rare is 4.44%（4/90）,invalid 0 cases.One month after surgery ,the cure rate in the control group was 76.67%（69/70）,the effective rate was 23.33%（21/90）,invalid 0 cases.Two months after surgery ,the cure rate was 80.00%（72/90）,the effective rate was 20.00%（18/90）,invalid 0 cases.The curative effect in the study group was superior to that in the control group （P〈0.05）.There was no significant difference in the amount of intraoperative bleeding and time of surgery between two groups（P〉0.05）.Six months after surgery,no cervical relaxation and cervical canal stenosis occurred in two groups.Conclusion The cervical canal mucosa circumcision in LEEP surgery can prevent postoperative cervical columnar epithelium valgus effectively .